| 引用本文: |
黄群, 曾茜萍, 谌芬, 杨楠.“通阳学说”在阳虚型肾性水肿中的应用探析[J].湖南中医药大学学报,2026,46(5):1031-1035[点击复制] |
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| “通阳学说”在阳虚型肾性水肿中的应用探析 |
| 黄群,曾茜萍,谌芬,杨楠 |
| (湖南中医药大学第一附属医院, 湖南 长沙 410007) |
| 摘要: |
| 阳虚型肾性水肿多因阳气不足、气化不利所致，临床多表现为水液泛溢于肌肤。其病机与肺、脾、肾三脏相关，病本在肾，病程可概括为水湿遏阳、寒湿凝滞、阴寒内盛、阳虚阴伤4个阶段。临床治疗应以淡渗通阳、辛温通阳、逐阴通阳、柔剂通阳为法，代表方剂包括防己黄芪汤、五苓散、参苓白术散、实脾饮、四逆汤、真武汤、济生肾气丸、金匮肾气丸加减。临证当依据病机审因论治，可单用或联用此四法，根据病程演变灵活加减用药，以期为临床治疗阳虚型肾性水肿提供新的中医治疗思路。 |
| 关键词: 肾性水肿|通阳学说|利小便|阳气亏虚|气化失司 |
| DOI：10.3969/j.issn.1674-070X.2026.05.023 |
| 投稿时间：2025-11-15 |
| 基金项目:湖南省卫生健康科研课题（20257525）；湖南中医药大学校院联合基金项目（2024XYLH037）。 |
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| Application of the "theory of unblocking yang" in renal edema with yang deficiency pattern |
| HUANG Qun, ZENG Xiping, SHEN Fen, YANG Nan |
| (The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan 410007, China) |
| Abstract: |
| Renal edema with yang deficiency pattern is mostly caused by insufficient yang qi and impaired qi transformation, clinically manifested as fluid overflowing into the skin and flesh. Its pathogenesis involves the lung, spleen, and kidney, with the root of the disease in the kidney. The disease course can be summarized into four stages, namely, water dampness obstructing yang, cold dampness stagnation, internal exuberance of yin cold, and yin injury due to yang deficiency. Accordingly, clinical treatment should adopt the methods of unblocking yang by draining dampness with bland herbs, unblocking yang with pungent-warm herbs, unblocking yang by expelling yin pathogens, and unblocking yang with mild formulas. Representative formulas include modified Fangji Huangqi Decoction, modified Wuling Powder, modified Shenling Baizhu Powder, modified Shipi Drink, modified Sini Decoction, modified Zhenwu Decoction, modified Jisheng Shenqi Pill, and modified Jingui Shenqi Pill. In clinical practice, treatment should be based on pathogenesis, with etiology-based identification; these four treatment methods can be used singly or in combination, with flexible modifications of herbs according to the disease course evolution, so as to provide a new Chinese medicine treatment approach for renal edema with yang deficiency pattern. |
| Key words: renal edema|theory of unblocking yang|promoting urination|yang qi deficiency|dysfunction of qi transformation |
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